Endogenous presumed bacterial endophthalmitis of the right eye following cellulitis of the right leg

Endogenous endophthalmitis is a very rare but potentially devastating intraocular inflammation resulting from haematogenous spread of pathogens to the eye. We present a case of a 26-year-old male adult who had a nail puncture injury to the sole of his right foot and developed swelling of the that foot and leg associated with severe pain and fever five days later. While being managed in a private clinic as a case of cellulitis of the right leg, he developed ocular pain, redness and diminution of vision in the right eye but was attended to five days later by the ophthalmologist who made a diagnosis of endogenous presumed bacterial endophthalmitis in an already blind right eye secondary to septicaemia. With 15 days of systemic antibiotics, the ocular and systemic findings resolved. The eye became pthisical on follow-up. Endogenous endophthalmitis is associated with poor visual prognosis and early intervention is the only sure way to improve visual outcome.